The use of nails to stabilize fractured thighbones has been practiced for some time as discussed in and taught by the improvements covered in the U.S. Pat. No. 3,433,220 to Zickel, Mar. 18, 1969 and U.S. Pat. No. 3,025,853 to Mason, Mar. 20, 1962. The Zickel patent shows a femoral rod or nail adapted to be inserted in the medullary canal of a thighbone to extend from the trochanter down the thighbone past the fractured area and into the distal portion of the fractured bone. After the fracture has been reduced, the femoral nail may be inserted while the reduction is maintained with suitable bone clamps and then when using the Zickel rod, a cross nail is driven through a tunnel in the femoral rod through the neck and into the head of the femur. The Zickel nailing appliance provides a pair of rods each one being especially shaped to fit either the right or left leg thighbone, thus requiring two differently shaped nails or rods having an enlarged head and specific shape to accommodate a crosspiece that must have a substantial diameter to support the cross bending forces transmitted between the femoral nail and crosspiece placed in the fractured bone while the patient recovers and the fracture heals.
In use, the Zickel nail requires that there be a precision fit between the crosspiece and the tunnel in the rod in order to properly insert the crosspiece in the femoral head. It may be necessary during the course of an operation to remove and reset the rod in a more precise position by extracting it from its position in the medullary canal after having embedded its enlarged head in the trochanter. The femoral rod is directed into such a position by means of its temporarily attached tunnel locator tool and when the rod has been turned to a new position, the rod is again driven into the medullary canal with an added possibility of slightly displacing some additional fragments of the fractured bone while enlarging the displacement of tissue in the greater trochanter as the enlarged head is driven home. The degree of change of rotation or depth of insertion of the Zickel rod may not be great but each manipulation requires the time and expert attention of the surgeon and carries with it the possibility of further damage resulting from the reinsertion process.